Provider Demographics
NPI:1083059430
Name:ROSSI, CHRISTA A (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTA
Middle Name:A
Last Name:ROSSI
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 MONTROSE AVE
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:NJ
Mailing Address - Zip Code:07044-1816
Mailing Address - Country:US
Mailing Address - Phone:973-951-8437
Mailing Address - Fax:
Practice Address - Street 1:271 ROUTE 46 W
Practice Address - Street 2:WEST D # 110
Practice Address - City:FAIRFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07004-2440
Practice Address - Country:US
Practice Address - Phone:973-951-8437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-29
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00325700174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist